A box of the diabetes drug Ozempic is seen on a pharmacy counter in this photo on April 17, 2023 in Los Angeles, California.
Mario Tama | Getty Images
People who take diabetes and weight loss medications such as Novo NordiskOzempic and Wegovy should stop taking them before scheduled surgery to reduce the risk of serious health complications, a prominent group of doctors said.
The American Society of Anaesthesiologists, an organization of more than 53,000 physicians working in anesthesiology, released preliminary guidance late Thursday with the proposal.
The purpose of the guidelines is to help physicians treat patients who are taking medication and are scheduled for elective surgeries, which are non-emergency surgeries such as kidney stone removal, joint replacement, and cosmetic surgery.
The ASA said the guidance reflects concerns related to delayed gastric emptying, or when food sits in the stomach longer than usual. This is an effect of diabetes and weight loss medications, which mimic a hormone produced in the gut called GLP-1 and ultimately suppress a person’s appetite.
Delayed gastric emptying can cause nausea, vomiting and aspiration in anesthetized patients, where a person accidentally inhales food into their lungs instead of swallowing it, according to the ASA.
For this reason, patients usually have to be sober before undergoing anesthesia for procedures.
The ASA has received isolated reports from across the US that patients taking the drugs while under general anesthesia or deep sedation may be at increased risk of these “serious” complications, said group president Dr. Michael Champeau, in the guidelines.
Ozempic and Wegovy are already associated with side effects such as diarrhea and constipation.
However, Champeau acknowledged that there is still a lack of scientific data on exactly how anesthesia interacts with these drugs, also known as GLP-1.
Every day around 60,000 people across the country receive general anesthesia or medication to relieve pain during surgeries and other procedures.
It’s unclear how many people take GLP-1 drugs each day, but their popularity has skyrocketed in the last year because they’re “miracles” for weight loss. Now Novo Nordisk’s Ozempic and Wegovy are suffering from nationwide shortages. They also face growing competition from similar treatments Eli LillyThis is Mounjaro.
According to ASA guidelines, people taking daily GLP-1 medications should skip treatment on the day of scheduled surgery.
Those who take GLP-1 weekly should stop treatment a week before scheduled surgery, the group said.
Before surgery, physicians should consider consulting an endocrinologist for advice for patients taking GLP-1 for diabetes.
The group also said doctors should consider postponing a patient’s procedure if they experience nausea, vomiting, or abdominal bloating or pain on the day of the scheduled procedure.
If a patient does not have any of these symptoms but has not stopped taking GLP-1 before surgery, doctors should consider using ultrasound to check if the stomach is “full.”